# Lumbosacral Spinal Stenosis - Non-Invasive Postural Therapy for Older Adult Veterans (LSS-NIPT)

> **NIH VA I21** · BALTIMORE VA MEDICAL CENTER · 2024 · —

## Abstract

Lumbosacral spinal stenosis (LSS) is a leading cause of limited mobility, reduced independence, and poor
health outcomes in older adults; and is especially prevalent in older adult Veterans. Several years ago, major
randomized clinical trials indicated that surgical intervention for LSS was more effective than usual (medical)
management. Nonetheless, there are many patients for whom surgery is not the ideal therapy. In some cases,
patients are not `good surgical candidates' due the presence multiple medical conditions such as [uncontrolled
type 2 diabetes mellitus (DM2)]. Other patients are considered less ideal for surgery because pain is a
prominent feature of their low back syndrome while simultaneously walking limitations, e.g., neurogenic
claudication, is less prominent. There is evidence that these patients are less likely to have good surgical
outcomes, and yet little is known about what other therapies might be effective. It is precisely the sickest and
most vulnerable patients with LSS who are in greatest need of alternative therapies. We propose a therapeutic
trial utilizing a low-cost, well-established non-invasive clinical device, repurposed for the relief of LSS-
associated pain. Current RR&D emphasis includes non-pharmacological treatments to improve
rehabilitation outcomes including pain and mobility. This proposal is based on the latest in peripheral
nerve research but takes a non-invasive approach to address a problem impacting a substantive percentage of
the millions of older adults with low back pain and dysmobility. Our specific aims include:
1. Gather and evaluate preliminary evidence that non-invasive postural therapy (NIPT) improves
rehabilitation outcomes including pain ratings and mobility over a 6-week pilot study of older adult
Veterans with LSS. In this study, 20 [older adult Veterans will receive instruction and equipment to support
holo-diurnal (all day-and-night) activity modification, e.g., modified walker use, adapted meal preparation /
leisure activities, and sleep positioning, to enhance sagittal flexion continuously and comfortably. Following 1
week baseline activity and sleep assessment, an initial 3-week treatment period (NIPT) will include activity
monitoring and daily pain assessment. During a second 3-week period, patients will use NIPT ad libitum,
activity and sleep monitoring will be repeated during week 6. The primary outcome measure is participant
mobility measured by actigraphy and pedometer. Secondary outcomes are patient-reported pain intensity and
interference, mobility, quality of life (PROMIS, EQ5D), and system usability; walker usage as measured by
tracking devices; as well as objective assessments of sleep duration and quality as measured by activity
monitoring.]
2. [Assess feasibility of, barriers to, and facilitators of non-invasive postural therapy (NIPT) holo-
diurnal implementation for older adult Veterans. The primary outcome in this arm of the study will be to
identify, through mixed met...

## Key facts

- **NIH application ID:** 10807747
- **Project number:** 1I21RX004412-01A1
- **Recipient organization:** BALTIMORE VA MEDICAL CENTER
- **Principal Investigator:** BETH B HOGANS
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-01-01 → 2025-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10807747

## Citation

> US National Institutes of Health, RePORTER application 10807747, Lumbosacral Spinal Stenosis - Non-Invasive Postural Therapy for Older Adult Veterans (LSS-NIPT) (1I21RX004412-01A1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10807747. Licensed CC0.

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